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Incident Reporting & Investigation

Who should complete the Incident Report Form? Any faculty member, staff member, student, visitor, volunteer or contractor who is involved in or observes an accident, potentially hazardous condition or "near miss" that does not involve an injury. Non-UMD employees who are injured should also use this form. The form should be completed as soon as possible after the incident occurs. This reporting form will be reviewed by Department of Environmental Safety, Sustainability and Risk personnel and followed up as appropriate. It can be anonymous, although insufficient contact information provided on the form may limit ESSR's ability to follow up.

If you are an employee of the university and have suffered an injury, you should skip this form and go directly to the Employee's First Report of Injury. This form will initiate a Worker's Compensation claim; additional forms at this link are required from your supervisor and any witnesses to the injury.

The objective of having a reporting system for incidents and injuries is to be able to investigate what went wrong that resulted in an injury or could have resulted in an injury (a near miss). Most injuries, even minor ones, are warnings that something happened that wasn't planned. If you find out what caused the incident, you can take steps to remedy the problem and prevent other incidents in the future. Supervisors/Managers can use the Incident Investigation Instructions and Incident Investigation Form to help them determine the causes or contributing factors of the incident and determine corrective actions.